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[染色体异常在后续妊娠中会再次出现吗?出现的频率如何?]

[Do chromosomal abnormalities reappear in subsequent pregnancies and how often?].

作者信息

Skrzypczak Jana, Kwinecka-Dmitriew Barbara, Zakrzewska Monika, Latos-Bieleńska Anna

机构信息

Klinika Rozrodczości, UM w Poznaniu.

出版信息

Ginekol Pol. 2010 Sep;81(9):681-6.

Abstract

OBJECTIVE

Genetic factors are the most common causes of spontaneous abortions. 50% to 80% of first-trimester abortions reveal-chromosome abnormalities. Evidence for the recurrence of the same or another chromosome abnormality in the next pregnancy is scarce.

THE AIM

The aim of our study was to estimate recurrence risk of abortus aneuploidy and to find out whether karyotyping of the abortus allows the prognose subsequent pregnancy outcomes.

MATERIAL AND METHODS

Paraffin-embedded chorions have undergone cytogenetic examination using FISH with chromosome-specific probes. 57 chorions from 26 women have been assessed, including chorions from two consecutive abortions from 18 women and chorions from three consecutive abortions from 5 women.

RESULTS

38.6% of 57 specimens had chromosome aberrations. The most prevalent anomalies were 16, 21 and 18 trisomies. 23 patients had a subsequent abortion karyotyped; 15 had a normal initial karyotype and 8 had an aberrant initial karyotype. 3 out of the 8 patients had a repeated chromosome anomaly 5 out of the 15 patients who initially miscarried an aneuploid embryo, had a subsequent miscarriage of an aneuploid embryo. Only 3 (13.04%) out of the 23 patients displayed aneuploidy in each abortus.

CONCLUSION

(1) Chromosome aberrations can reappear in subsequent pregnancies in the same patient and may be the cause of recurrent miscarriages. (2) The value of embryo/fetal karyotyping is not decisive in prognosis of subsequent pregnancy outcome. (3) Abnormal fetal karyotype can occur regardless of other causes of pregnancy loss.

摘要

目的

遗传因素是自然流产最常见的原因。孕早期流产中有50%至80%显示染色体异常。下一胎妊娠出现相同或其他染色体异常复发的证据很少。

目的

我们研究的目的是评估流产非整倍体的复发风险,并确定流产组织的核型分析是否能预测后续妊娠结局。

材料与方法

使用染色体特异性探针的荧光原位杂交技术对石蜡包埋的绒毛进行细胞遗传学检查。对26名女性的57份绒毛进行了评估,包括18名女性连续两次流产的绒毛以及5名女性连续三次流产的绒毛。

结果

57个样本中有38.6%存在染色体畸变。最常见的异常是16、21和18三体。23例患者后续流产进行了核型分析;15例初始核型正常,8例初始核型异常。8例患者中有3例出现重复的染色体异常,15例最初流产的非整倍体胚胎的患者中,有5例后续流产的也是非整倍体胚胎。23例患者中只有3例(13.04%)每次流产均显示非整倍体。

结论

(1)染色体畸变可在同一患者的后续妊娠中再次出现,可能是反复流产的原因。(2)胚胎/胎儿核型分析对后续妊娠结局的预后价值不具有决定性。(3)无论妊娠丢失的其他原因如何,均可出现胎儿核型异常。

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